Astegolimab (Roche/Genetech) anti-ST2 failed to meet the primary endpoint (COPD exacerbation reduction in a recent phase III study (ARNASA) although in a phase 2b study (ALIENTO) a small (15.4%), but statistically significant, reduction in COPD exacerbations was seen (166). This evidence concerns the gene IL1RL1 and chronic obstructive pulmonary disease.